Tumor and congenital diseases of uvea
Iris cyst（虹膜囊肿） Malignant melanoma of the choroid（脉络膜恶性黑色素瘤） Metastatic carcinoma of the choroid（脉络膜转移瘤） Uveal coloboma（葡萄膜缺损）
Fine, dust-like KPs — neutrophile granulocyte，
lymphocyte，plasmacyte；herpetic uveitis, Fuchs syndrome
Large, white，“mutton fat”-like KPs—
Mononuclear macrophages，epithelioid cell ；granulomatous iridocyclitis
DISEASE OF THE UVEA （葡萄膜疾病）
uvea
Uveal tract: iris, the ciliary body and the choroid
uvea
choroid
well vascularized - nutrition and removal of metabolic waste
Trauma
eye injury, surgery : release arachidonic acid - a potent inflammatory mediator
Genetic associations
Ankylosing spondylitis - HLA-B27 Bechet's disease - HLA-B51 VKH - HLA-DR4
Sclerotic
Outline
Uveitis (Causes, etiology and classification of uveitis)
Anterior Uveitis（前葡萄膜炎） Intermediate Uveitis（中间葡萄膜炎） Posterior Uveitis（后葡萄膜炎பைடு நூலகம் Panuveitis（全葡萄膜炎）
A) Ciliary Injection
B) Episcleral Injection C) Conjunctival Injection
Grade 0 1/2
1 to 1+ 2 to 2+ 3 to 3+
Severity White and Quiet Slight, Usually Normal
Mild Moderate
Severe
Conjunctival injection
Ciliary injection
festooned pupil
Keratic precipitates, KP
Cells or pigments deposit on the back surface of the cornea
Classification of Uveitis
Aetiological
infectious, noninfectious
Pathological
granulomatous（肉芽肿性）, nongranulomatous（非 肉芽肿性）
Anatomical
anterior, intermediate, posterior, panuveitis
Anterior Uveitis
Signs
injection(ciliary or mixed) 睫状或混合充血 Keratic precipitates, KP 角膜后沉着物 anterior chamber flare 前方闪辉 anterior chamber cell 前方细胞 posterior or anterior synechiae of the iris
melanocytes - dark background
Membrana Limitans Interna
Pigment Cell Layer Internal Vascular Portion of the Choroid External Vascular Portion of the Choroid
Uveitis
Definition: An inflammation of the uveal tract
Causes of Uveitis
Infection
bacteria, virus(eg herpes疱疹病毒), fungus, parasite
Immune response
autoimmune antigen : retinal S, IRBP(interphotoreceptor retinoid-binding protein) immune-complexes mediated reaction
Some specific uveitis
Sympathetic ophthalmia（交感性眼炎） VKH syndrome（Vogt-小柳原田综合症） Anterior Uveitis associated with Ankylosing spondylitis（强直性脊柱炎） Behcet’s syndrome Fuchs syndrome ARN syndrome（急性视网膜坏死综合症）
Clinical
acute(<3months), chronic(>3months)
Anterior Uveitis - iritis & iridocyclitis
Symptoms
redness, pain, photophobia, tearing, floaters, decreased vision…
虹膜后粘连或前粘连 iris nodules 虹膜结节 seclusion or occlusion of the pupil
瞳孔闭锁或瞳孔膜闭 some fibrinous pigmented deposits in the pupillary
area of the lens 瞳孔区晶体前表面纤维色素沉着